Spinal Cord Cavernous Malformation

Dr. Katharine Tansavatdi discusses the MRI appearance, differential diagnosis, and management of a characteristic spinal cord lesion.

Dorsal Arachnoid Webs

Dr. Malisa Lester discusses the imaging and clinical features of an intraspinal abnormality in which the MR diagnosis may be challenging.

Chronic Recurrent Multifocal Osteomyelitis

A 10 year-old female presents with a several-week history of atraumatic pain and swelling in the right clavicular region. A frontal radiograph with 15-degree cephalic angulation (1a) and a fat-suppressed coronal proton density-weighted image (1b) are provided. What are the findings? What are your diagnostic considerations?

Congenital and Acquired Hypertrophic Peripheral Neuropathies

A 55-year-old female presents with constant lower back pain and extremity numbness. Sagittal and parasagittal T2-weighted images (1a-b) of the lumbar spine and axial T2-weighted images at the L4-5 (1c) and S1 levels (1d) are provided. 

Facet Synovitis

A 69-year-old female presents with low back pain, bilateral buttock, and posterior right thigh pain, aggravated when moving from seated to standing position. The patient denies radicular type symptoms. On exam, the patient demonstrates increased pain with hyperextension and lateral movements in hyperextension. There is point tenderness over the paraspinal lower lumbar levels greater on the left. Sagittal STIR (1a and 1b) and axial T2-weighted (1c) and T1-weighted (1d) images are provided.

Serous Atrophy

A 22-year-old female runner presents with worsening right foot pain with running and prolonged weight-bearing. Sagittal T1-weighted (1a) and STIR (1b), axial T1-weighted (1c) and fat-suppressed T2-weighted (1d), as well as coronal T2 Dixon Fat (1e) and T2 Dixon Water (1f) images are provided. What are the findings? What is your diagnosis?

Myxopapillary Ependymoma

A 35-year-old woman presents with low back and right leg pain that began during pregnancy four years previously. Sagittal T1- and T2-weighted (1a and 1b), T1-weighted post-gadolinium (1c), axial T2-weighted (1d) and T1-weighted post-gadolinium axial images (1e) are provided.

Dural Ectasia

An 18 year-old male undergoes MRI for low back pain. Sagittal T2-weighted (1a), sagittal T1-weighted (1b), and axial T1-weighted (1c) and axial T2-weighted (1d) images at the level of S1 are provided.

Non-degenerative Disease of the Peripheral Nerves

A 30 year-old male who was involved in a high-speed motor vehicle accident 10 months prior. Axial T2-weighted (1A) and T1-weighted (1B) images are provided. What are the findings? What is your diagnosis?

Intravertebral Cleft Sign

A 78 year-old male presents with low back pain radiating into the mid back for 3 months due to 4 falls. Sagittal T2-weighted (1a), sagittal T1-weighted (1b), sagittal STIR (1c) image and lateral radiograph (1d) obtained around the time of presentation for pain are provided.

Baastrup’s Disease

An 84 year-old female presents with low back pain, right leg pain, hip pain, numbness and weakness.

Pseudomeningocele

35 year-old obese female was status post a recent microdiscectomy at L4-5 with resolution of radicular symptoms. Three days post-operatively she developed headaches and episodic recurrent left radicular symptoms.

Klippel Feil Syndrome

A 60 year-old woman presented to her physician complaining of upper and lower extremity pain. A (1a) T2-weighted sagittal MR image and (1b) sagittal and (1c) coronal cervical spine CT images are provided.

Intraosseous Pneumatocyst

A 50 year-old man was involved in a motor vehicle accident with complaints of shoulder and neck pain.

The Owl’s Eyes Sign

A 52 year-old male presents to his orthopaedic surgeon complaining of chronic bilateral hand numbness and tingling.

Chiari I Malformation

A 36 year-old female presents with neck pain and headaches. A sagittal T1-weighted image of the brain is provided (A). What is the finding? What is your diagnosis?

Bertolotti’s Syndrome

Clinical History: A 66 year-old male presents to his doctor's office with a longstanding history of low back and leg pain. On physical exam he demonstrates a left L5 radiculopathy. The patient is referred for an MRI of the lumbar spine. (1a,b) T2-weighted coronal and...

Discitis

Clinical history: A 91 year-old woman complains of low back pain. A routine lumbar spine MR with (1a) T1-weighted sagittal and (1b,1c) T2-weighted sagittal and axial images was performed. What are the findings? What is your diagnosis?   Findings...

Pathologic Fractures

Clinical History: A 58 year-old female with Stage 3A breast cancer presents to her family physician with back pain. A radiograph reveals a severe L1 compression fracture. She is referred to an orthopaedist. On physical exam she exhibits axial type pain without...

Acute Injuries of the Lumbar Neural Arch in Adolescents

Clinical History Case 1: 13 year old male track and field athlete with constant back pain, increased with running.(1a,1b) Sagittal STIR image right and left of midline and (1c) axial T2 weighted images are provided. What are the findings? What is your diagnosis?...

Evaluating the Varied Appearances of Normal and Abnormal Marrow

Clinical History: A 43 year old male presents with radicular type pain. Past medical history is non-contributory. (1a) T1- and (1b) T2-weighted sagittal and (1c) T1-weighted axial images are provided. The imaging findings are such that the radiologist feels compelled...

Tight Filum Syndrome

Clinical History: A 59 year-old woman complains of chronic low back pain and bilateral foot paresthesias. Her knee and ankle reflexes are brisk. On further questioning, she relates a history of stress incontinence diagnosed by her family physician. (1a,1b) T1 and...

Spondylolisthesis, Spondylolysis

Clinical History: A 22 year-old man presents with right-sided back pain which radiates to his right hip and leg. His symptoms began while running. (1a) T1- and (1b) T2-weighted sagittal and (1c) T2-weighted axial images of the lumbar spine are provided. What are the...

Ventriculus Terminalis

Clinical History: A 47 year-old man presents with chronic right hip and leg pain. Reflexes are normal. No weakness is found on physical exam. The patient denies bowel or bladder dysfunction. (1a) T2-weighted sagittal and (1b) axial images of the lumbar region are...

Spine Nomenclature

Clinical History: A 32-year old female presents with back and left leg pain. (1a) T2-weighted sagittal and (2a) T1-weighted axial images are provided.   The best diagnosis in this case is: Herniated nucleus pulposus Disc protrusion...

Sacral Insufficiency Fractures

Clinical History: A 73-year-old female presents with chronic low back pain with recent worsening in severity. Sagittal (1a) T1 and T2-weighted images are provided. What are the findings? Which of the findings is the most likely cause of her worsening pain? [figure...

Arachnoiditis

Clinical History: A 67 year old man presents with a history of chronic low back pain radiating into both buttocks, the back of both legs, and into the calves. He also complains of paresthesias manifested as a "pins and needles" sensation in a non-dermatomal pattern....

Vertebral Hemangioma

Clinical History: A 46 year-old female with a history of breast cancer presents with low back pain. (1a) Sagittal T2-weighted, (1b) sagittal T1-weighted and (1c) axial T1-weighted images are provided. What are the findings" What is your diagnosis? ...

Lumbar Synovial Cyst

Clinical History: A 53 year old female presents with back and left leg pain. A T1-weighted sagittal image (1a) and a fast spin-echo T2 weighted axial (1b) image are provided. What are the findings" What is your diagnosis? Findings ...

Free Disc Fragment

Clinical History: 55 year-old man with right leg pain. T1-weighted sagittal (1a), T2-weighted sagittal (1b) and T2-weighted axial (1c) images are provided. What is your diagnosis? Findings Answer Right paracentral free disc fragment from...

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